Comedienne Joan Rivers went into cardiac arrest last week during an outpatient procedure.

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Comedienne and talk show host Joan Rivers was reportedly in a medically-induced coma, following throat surgery and subsequent cardiac arrest at a Manhattan clinic.

What is a medically-induced coma? It's one of the ways doctors control swelling of the brain after trauma, in an effort to prevent brain damage and even death.

When the brain is injured, it can swell and put so much pressure on the skull that the blood supply is cut off. One way to prevent this swelling is to cool the body to about 90 degrees (similar to putting ice on a swollen ankle). Another is to give an intravenous drug called mannitol, which reduces the water volume in the brain. Sedating the patient, lowering her blood pressure and increasing her breathing rate (such patients are always on a ventilator – a breathing machine – so the respiratory rate can be controlled mechanically) are also methods used to lower the intracranial pressure. Sometimes surgery is done to either remove dead brain tissue or to create more space for the swollen brain.

If these methods don’t work, a medically-induced coma — a state of deep unconsciousness — is the last resort.

Here's how it works: An anesthesiologist is called in to initiate the process. The patient is given either pentobarbital (a barbiturate) or propofol (a sedative), either of which induce profound coma. The patient's brain wave activity goes flat, and he or she becomes unresponsive to all external stimuli (pain, light, noise, etc.). The basic idea is to put the brain to rest by closing down as much activity as possible. Doctors monitor the intracranial pressure in order to determine how long to maintain the coma, which can be risky.

Medically-induced coma is a controversial procedure and not all doctors are convinced of its effectiveness. Joan Rivers's family says they are keeping their fingers crossed.

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